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<title>提供团购信息 | 玩乐团</title>
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<body>
<div id="container">
  <div id="doc">
  <jsp:include page="/template/top.jsp"></jsp:include>
<!-- 通栏广告 -->
	<div id="sysmsg-error-box">
      <div id="sysmsg-error" class="sysmsgw hidd">
        <div class="sysmsg"><span></span><span class="close">关闭</span></div>
      </div>

      <div id="sysmsg-success" class="sysmsgw hidd">
        <div class="sysmsg"><span></span><span class="close">关闭</span></div>
      </div>
    </div>
    <div id="bd" class="cf">
        <div id="feedback">
          <div id="content" class="help">
            <div class="box">

              <div class="box-top"></div>
              <div class="box-content">
                <div class="head">
                  <h2>提供团购信息</h2>
                </div>
                <div class="sect" id="feedbackdiv">
                  <p class="notice">特别欢迎优质商家、淘宝大卖家提供团购信息。</p>
                  <form id="feedback-user-form" method="post" action="http://www.wanletuan.com/feedback/seller/">

                    <div class="field fullname">
                      <label for="feedback-fullname">您的称呼</label>
                      <input type="text" size="30" name="name" id="feedback-fullname" class="f-input" value=""/>
                    </div>
					 <div class="field mobile">
                            <label for="feedback-mobile">您的电话</label>
                            <input type="text" size="30" name="mobile" id="feedback-email-address" class="f-input" value=""/>
                        </div> 
                    <div class="field email">

                      <label for="feedback-email-address">其他联系方式</label>
                      <input type="text" size="30" name="email" id="feedback-mobile" class="f-input" value=""/>
                      <span class="hint">请留下您的手机、QQ号或邮箱，方便联系</span> </div>
					  
					  
					  <div class="field city">
                            <label for="feedback-city">城市</label><select name="cityid" id="feedback-city" class="f-select" autocomplete="off">
                           <option value='41' >全国</option><option value='35'  selected >石家庄</option><option value='38' >杭州</option><option value='70' >台州</option><option value='53' >武汉</option><option value='15' >北京</option><option value='17' >上海</option><option value='71' >天津</option><option value='67' >推广</option></select>

                        </div>
                        <div class="field bizname">
                            <label for="feedback-bizname">团购商家名称</label>
                            <input type="text" size="30" name="bizname" id="feedback-bizname" class="f-input" value=""/>
                        </div>
                        <div class="field category">
                            <label for="feedback-category">团购类型</label>
                            <select name="type" id="feedback-category" class="f-select">

                            <option value="餐馆美食">餐馆美食</option><option value="休闲娱乐">休闲娱乐</option><option value="丽人">丽人</option><option value="健康保健">健康保健</option><option value="运动健身">运动健身</option><option value="电商网店">电商网店</option><option value="其它">其它</option>                            </select>
                        </div>
                    <div class="field suggest">
                      <label for="feedback-suggest">团购信息</label>

                      <textarea cols="30" rows="5" name="content" id="feedback-suggest" class="f-textarea"></textarea>
                    </div>
                    <div class="clear"></div>
                    <div class="act"><input type="hidden" name="styleid" id="feedback-styleid" value="1">
                      <input type="submit" value="提交" name="commit" id="feedback-submit" class="formbutton"/>
                    </div>
                  </form>
                </div>

              </div>
              <div class="box-bottom"></div>
            </div>
          </div>
        </div>
      </div>
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